PURPOSE: To demonstrate a potential cause of a prolonged epidemic of diffuse lamellar keratitis (DLK). METHOD: This retrospective review analyzed an epidemic of diffuse lamellar keratitis over a 3-year period in a single surgery center. Altering the brand of surgical gloves used during surgery was associated with an elimination of the DLK epidemic. Optical microscopy, scanning electron microscopy-energy dispersive spectroscopy (SEM-EDS), and Fourier transform infrared (FTIR) spectroscopy were performed on both brands of surgical gloves to allow for comparisons and determine possible surface contaminants responsible for the DLK outbreaks. RESULTS: The incidence of DLK during the epidemic ranged from 2% to 38% on a quarterly basis for the 3-year period. A change in the brand of surgical gloves resulted in a cessation of DLK. Surface analysis of both brands of gloves revealed extensive silicone oil contamination on the internal and external surfaces of the DLK-associated gloves and insignificant amounts of silicone oil on the external surface of the DLK-free gloves. CONCLUSION: Silicone oil contamination of surgical gloves appears to be associated with epidemic DLK.
PURPOSE: To demonstrate a potential cause of a prolonged epidemic of diffuse lamellar keratitis (DLK). METHOD: This retrospective review analyzed an epidemic of diffuse lamellar keratitis over a 3-year period in a single surgery center. Altering the brand of surgical gloves used during surgery was associated with an elimination of the DLK epidemic. Optical microscopy, scanning electron microscopy-energy dispersive spectroscopy (SEM-EDS), and Fourier transform infrared (FTIR) spectroscopy were performed on both brands of surgical gloves to allow for comparisons and determine possible surface contaminants responsible for the DLK outbreaks. RESULTS: The incidence of DLK during the epidemic ranged from 2% to 38% on a quarterly basis for the 3-year period. A change in the brand of surgical gloves resulted in a cessation of DLK. Surface analysis of both brands of gloves revealed extensive silicone oil contamination on the internal and external surfaces of the DLK-associated gloves and insignificant amounts of silicone oil on the external surface of the DLK-free gloves. CONCLUSION:Silicone oil contamination of surgical gloves appears to be associated with epidemic DLK.
Authors: Fernando H de Paula; Christian G Khairallah; Leslie M Niziol; David C Musch; Roni M Shtein Journal: J Cataract Refract Surg Date: 2012-04-08 Impact factor: 3.351
Authors: Christina H Choe; Carly Guss; David C Musch; Leslie M Niziol; Roni M Shtein Journal: J Cataract Refract Surg Date: 2010-11 Impact factor: 3.351